Print ID P1719 Version 3.0 date 10/09/2019 Chronic Hepatitis C Referral Pathway Potential Risk Factors Identified [1] Unexplained abnormal liver function tests or unexplained jaundice Pre-test discussion & Informed Consent Pathology Collected – HCV Antibody HCV Ab INTERMEDIATE HCV Ab POSITIVE HCV Ab NEGATIVE (Does not have hepatitis) Inform client and post-test discussion Repeat at 1-2 months if acute infection suspected Further Pathology Collected – HCV RNA PCR – E/LFT’s HCV RNA PCR POSITIVE HCV RNA PCR NEGATIVE Active Infection Inform client and post-test discussion With clients consent refer to: Blood Borne Virus & Sexual Health Service with relevant pathology to further assess liver disease (see over page) Likely past infection with viral clearance OR if liver enzymes abnormal possible low viral load Repeat HCV RNA in 6 months if infection still a concern Repeat at 1-2 months if acute infection suspected 1. Testing is indicated for people who have risk factors associated with transmission of HCV. In appropriate clinical circumstances, the absence of declared risk factors should not preclude HCV testing. These risk factors include, but are not limited to: - People who are or have ever been incarcerated - People who have ever injected drugs - Aboriginal and Torres Strait Islander populations - People born in countries with high HCV prevalence
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Print ID P1719 Version 3.0 date 10/09/2019
Chronic Hepatitis C Referral Pathway
Potential Risk Factors
Identified [1]
Unexplained abnormal liver function tests or unexplained jaundice
Pre-testdiscussion &
Informed Consent
Pathology Collected – HCV
Antibody
HCV Ab INTERMEDIATE
HCV Ab POSITIVE
HCV Ab NEGATIVE(Does not have hepatitis)
Inform client and post-test
discussion
Repeat at 1-2 months if acute infection suspected
Further Pathology Collected
– HCV RNA PCR – E/LFT’s
HCV RNA PCR POSITIVE
HCV RNA PCR NEGATIVE
Active Infection
Inform client and post-test discussion
With clients consent refer to:Blood Borne Virus & Sexual Health Service
with relevant pathology to further assess liver disease(see over page)
Likely past infection with viral clearanceOR if liver enzymes abnormal
possible low viral loadRepeat HCV RNA in 6 months
if infection still a concern
Repeat at 1-2 months if acute infection suspected
1. Testing is indicated for people who have risk factors associated with transmission of HCV. In appropriate clinical circumstances, the absence of declared risk factors should not preclude HCV testing. These risk factors include, but are not limited to:
- People who are or have ever been incarcerated - People who have ever injected drugs - Aboriginal and Torres Strait Islander populations - People born in countries with high HCV prevalence
Central Queensland Hospital and Health Service
Print ID P1719 Version 3.0 date 10/09/2019 Page 2 of 2
Referral Investigations
If the HCV RNA PCR test is POSITIVE
Please complete the followingInvestigations prior to referral to the
Blood Borne Virus & Sexual Health Services
HCV RNA Viral Load & GenotypeHepatitis A IgG
Hepatitis B Serology (HBsAG, HBcAb, HBsAb titre level)Urea & Electrolytes